House Select Committee on Childhood Obesity : report to the 2012 regular session of the 2011 General Assembly

HOUSE SELECT COMMITTEE ON
CHILDHOOD OBESITY
REPORT TO THE 2012
REGULAR SESSION
OF THE 2011
GENERAL ASSEMBLY
NORTH C AROL INA G ENE R A L A S S E M B LY
A LIMITED NUMBER OF COPIES OF THIS REPORT IS AVAILABLE
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TABLE OF CONTENTS
LETTER OF TRANSMITTAL .......................................................................................................................... 1
COMMITTEE MEMBERSHIP ......................................................................................................................... 2
AUTHORIZING LEGISLATION. .................................................................................................................. 4
OVERVIEW OF COMMITTEE PRESENTATIONS ................................................................................. 6
SUMMARY OF COMMITTEE PROCEEDINGS ........................................................................................ 9
COMMITTEE FINDINGS AND RECOMMENDATIONS ..................................................................... 15
LEGISLATIVE PROPOSAL I – AN ACT TO APPROPRIATE FUNDS TO THE
DEPARTMENT OF PUBLIC INSTRUCTION FOR THE CHILD NUTRITION
PROGRAM TO ASSIST CHILD NUTRITION PROGRAMS IN MEETING
NUTRITION STANDARDS, AS RECOMMENDED BY THE HOUSE SELECT
COMMITTEE ON CHILDHOOD OBESITY. ............................................................................................. 22
LEGISLATIVE PROPOSAL II – AN ACT TO APPROPRIATE FUNDS TO THE
DEPARTMENT OF PUBLIC INSTRUCTION FOR THE CHILD NUTRITION
PROGRAM TO ELIMINATE THE STUDENT COST FOR REDUCED-PRICE
BREAKFAST IN ORDER TO INCREASE BREAKFAST PARTICIPATION, AS
RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON CHILDHOOD
OBESITY ............................................................................................................................................................... 23
LEGISLATIVE PROPOSAL III – AN ACT TO APPROPRIATE FUNDS TO THE
DEPARTMENT OF PUBLIC INSTRUCTION TO OFFSET THE COST OF SALARY
AND BENEFIT INCREASES REQUIRED BY THE STATE FOR CHILD
NUTRITION PERSONNEL IN LOCAL SCHOOL ADMINISTRATIVE UNITS, AS
RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON CHILDHOOD
OBESITY ............................................................................................................................................................... 24
LEGISLATIVE PROPOSAL IV – AN ACT TO REDUCE CHILD NUTRITION
PROGRAM FOOD COSTS BY ENCOURAGING PARTICIPATION IN THE NORTH
CAROLINA PROCUREMENT ALLIANCE AND BY APPROPRIATING FUNDS FOR
ADMINISTRATIVE SUPPORT FOR THE PROCUREMENT ALLIANCE; AND
ENCOURAGING USE OF THE FARM TO SCHOOL PROGRAM AND BY
APPROPRIATING FUNDS FOR CHILD NUTRITION EQUIPMENT TO
ENCOURAGE CONSUMPTION OF LOCALLY GROWN FRUITS AND
VEGETABLES, AS RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON
CHILDHOOD OBESITY ................................................................................................................................. 25
LEGISLATIVE PROPOSAL V – AN ACT TO SAVE MONEY BY REMOVING
LOCAL SCHOOL ADMINISTRATIVE UNITS FROM THE SEPARATE BID
REQUIREMENTS FOR JUICE AND WATER, AS RECOMMENDED BY THE
HOUSE SELECT COMMITTEE ON CHILDHOOD OBESITY ........................................................... 27
LEGISLATIVE PROPOSAL VI – AN ACT TO DIRECT THE STATE BOARD OF
EDUCATION AND THE DEPARTMENT OF PUBLIC INSTRUCTION TO
DETERMINE OPTIMAL SEAT TIME FOR STUDENTS EATING MEALS IN
PUBLIC SCHOOLS AND TO EXPLORE MEAL TIME OPTIONS, AS
RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON CHILDHOOD
OBESITY ............................................................................................................................................................... 28
LEGISLATIVE PROPOSAL VII – AN ACT TO WORK TOWARD DECREASING
OBESITY IN SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)
PARTICIPANTS BY INCREASING THEIR PARTICIPATION IN SUPPLEMENTAL
NUTRITION ASSISTANCE PROGRAM EDUCATION (SNAP-ED) AND MAKING
FRESH, LOCALLY GROWN PRODUCE AVAILABLE BY INCREASING THE
ACCEPTANCE OF ELECTRONIC BENEFITS TRANSFER (EBT) CARDS AT
FARMERS MARKETS, AS RECOMMENDED BY THE HOUSE SELECT
COMMITTEE ON CHILDHOOD OBESITY .............................................................................................. 29
LEGISLATIVE PROPOSAL VIII – AN ACT TO CONTINUE THE WORK OF THE
SUSTAINABLE LOCAL FOOD ADVISORY COUNCIL, AS RECOMMENDED BY
THE HOUSE SELECT COMMITTEE ON CHILDHOOD OBESITY ................................................. 30
LEGISLATIVE PROPOSAL IX – AN ACT TO ESTABLISH THE TASK FORCE ON
PHYSICAL EDUCATION AND PHYSICAL ACTIVITY IN SCHOOLS AND TO
DIRECT THE STATE BOARD OF EDUCATION TO COORDINATE A WORK
GROUP TO EXAMINE THE CURRENT STATUS OF DATA COLLECTION FROM
FITNESS TESTING CONDUCTED IN KINDERGARTEN THROUGH EIGHTH
GRADE, AS RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON
CHILDHOOD OBESITY ................................................................................................................................. 31
1
STATE OF NORTH CAROLINA
HOUSE SELECT COMMITTEE ON CHILDHOOD OBESITY
April 25, 2012
TO THE MEMBERS OF THE 2012 REGULAR SESSION OF THE 2011 GENERAL
ASSEMBLY:
Attached for your consideration is the report to the 2012 Regular Session of the 2011
General Assembly. This report was prepared by the House Select Committee on Childhood
Obesity pursuant to G.S. 120-19.6(a1) and Rule 26 of the Rules of the House of
Representatives of the 2011 General Assembly.
Respectfully submitted,
____________________________ ____________________________
Representative Stephen LaRoque Representative Norman Sanderson
Cochair Cochair
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COMMITTEE MEMBERSHIP
House Select Committee on Childhood Obesity
Rep. Stephen LaRoque, Chair Rep. Norman Sanderson, Chair
P. O. Box 1034 269 Bennett Rd. #4
Kinston, NC 28503 Arapahoe, NC 28510
Stephen.LaRoque@ncleg.net Norman.Sanderson@ncleg.net
Office: (252)523-7700 Office: (252) 249-3749
Cell: (252) 560-3399 Cell:
Rep. Marcus Brandon Rep. Larry Brown
200 Oak St., Apt. 3 P.O. Box 85
High Point, NC 27260 Kernersville, NC 27285
Marcus.Brandon@ncleg.net Larry.Brown@ncleg.net
Office: (336) 987-3357 Office: (336) 972-4256
Cell: Cell:
Rep. Rayne Brown Rep. Verla Insko
416 Lee Ave. 610 Surry Rd.
Lexington, NC 27295 Chapel Hill, NC 27514
Rayne.Brown@ncleg.net Verla.Insko@ncleg.net
Office: (336) 249-2608 Office:
Cell: Cell:
Rep. Linda Johnson Rep. Chuck McGrady
1205 Berkshire Dr P. O. Box 723
Kannapolis, NC 28081 Hendersonville, NC 28793
Linda.Johnson2@ncleg.net Chuck.McGrady@ncleg.net
Office: (704) 932-1376 Office: (828) 692-3696
Cell: Cell:
Rep. Garland Pierce
21981 Buie St.
Wagram, NC 28396
Garland.Pierce@ncleg.net
Office: (910) 369-2844
Cell:
3
Staff
Sara Kamprath, Research Division
Patsy Pierce, Research Division
Theresa Matula, Research Division
Dee Atkinson, Research Division
Lisa Wilks, Bill Drafting Division
Lisa Hollowell, Fiscal Research Division
Denise Thomas, Fiscal Research Division
Committee Clerks
Lisa Kennedy
Kathy Voss
AUTHORI Z IN
4
NG LEGISLATION
5
6
OVERVIEW OF COMMITTEE
PRESENTATIONS
The House Select Committee on Childhood Obesity met 5 times from November 10,
2011 until April 25, 2012.
November 10, 2011
Committee Authorization/Budget
Sara Kamprath, Committee Staff
Enacted Legislation Related to Childhood Obesity (2008-2011)
Theresa Matula, Committee Staff
Overview of the Problem of Childhood Obesity in North Carolina
Dr. Joseph Skelton, MD, Section of Pediatric Gastroenterology and Nutrition
Department of Pediatrics, Wake Forest University School of Medicine
Department of Public Instruction Activities
Healthful Living Essential Standards
Ellen Essick, Coordinated School Health Consultant
NC Healthy Schools, DPI
Healthy Active Children Policy
State Board of Education Policy Regarding Physical Activity in the Public Schools
Paula Hudson Hildebrand, Chief Health and Community Relations Officer, DPI
Fitness Testing Guidelines: Implementation of HB 1757
Paula Hudson Hildebrand, Chief Health and Community Relations Officer, DPI
IsPOD (In-School Prevention of Obesity and Disease)
Judy Martino, Assistant Executive Director for Grants & Special Programs, NCAAHPERD
Physical Activity Initiatives for Early Childhood Programs
Lori Rhew, MA, PAPHS, Physical Activity Unit Manager
Physical Activity and Nutrition Branch
North Carolina Division of Public Health, Department of Health and Human Services
Alice Lenihan, MPH, RD, LDN, Branch Head
Nutrition Services Branch, North Carolina Division of Public Health, Department of Health
and Human Services
Wendi Boggess, Family Relations Specialist
First Environments Early Learning Center
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Middle School Sport Policies and Sport Participation
Dr. Michael Kanters, Associate Professor
Department of Parks, Recreation & Tourism Management, NCSU
December 8, 2011
S.L. 2010-117 (HB 1726), Improve Childcare Nutrition Standards
Jani Kozlowski, Director's Office, Policy Unit Manager, Division of Child Development and
Early Education
Alice Lenihan, Branch Head, Nutrition Services Branch, Division of Public Health
School Nutrition Program
Lynn Harvey, Section Chief, Child Nutrition Services, DPI
NC General Assembly Program Evaluation Division
Child Nutrition Programs Study Report
Carol Ripple, Principal Evaluator
Fresh and Local Food in Communities
Alice Ammerman, Director, Center for Health Promotion and Disease Prevention, UNC-CH
Professor, Department of Nutrition, Gillings School of Global Public Health and School of
Medicine, UNC-CH
January 12, 2012
Eligibility for Food and Nutrition Services (FNS) Benefits
David Locklear, Assistant Chief, Economic and Family Services Section, Department of
Health and Human Services
SNAP-Ed
Veronica Bryant, SNAP-Ed Outreach Coordinator, Department of Health and Human
Services
North Carolina Farm to School Program
Gary Gay, Food Distribution Division, Department of Agriculture and Consumer Services
National Farm to School Network
Laurie Stradley, State Lead for the National Farm to School Network
North Carolina Sustainable Local Food Advisory Council Recommendations from
2011 Annual Report
Joy Hicks, Policy Development Analyst, Department of Agriculture and Consumer Services
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February 15, 2012
Good Agricultural Practices (GAP) Certification as it Relates to Farm to School
Heather Barnes, Farm to School, NC Department of Agriculture
Brooke Stephenson, Marketing Division, NC Department of Agriculture
Small Farms and GAPs: Addressing On-the-Ground Challenges
Roland McReynolds, Executive Director, Carolina Farm Stewardship Association
Child Nutrition Issues: A Local Perspective
Pam Smith, Child Nutrition Director, Lenoir County Schools
Healthy Active Children Policy Report
Paula Hudson Hildebrand, Chief Health and Community Relations Officer, DPI
Physical Education Success Stories
Dr. Patrick Miller, Superintendent, Greene County Schools
Angie Miller, Healthful Living Coordinator, Nash-Rocky Mount Public School System
New Federal Child Nutrition Standards and Possible Local Impact
Lynn Harvey, Section Chief, Child Nutrition Services, DPI
April 25, 2012
Committee Report
Review of Draft Report
Committee Discussion
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COMMITTEE PROCEEDINGS
This section of the report provides a brief summary of the Committee meetings. It is not
intended to be a complete, official record of those meetings. However, there is an official
record of the Committee’s meetings, including minutes and handouts distributed to the
Committee members, in the Legislative Library.
November 10, 2011
Ms. Sara Kamprath, Legislative Analyst, Research Division, General Assembly reviewed the
authorizing legislation and budget for the Committee.
Ms. Theresa Matula, Legislative Analyst, Research Division, General Assembly, reviewed
enacted legislation from 2008 through 2011 related to childhood obesity to give Committee
members context on what has happened and what may still need to be enacted to help to
reduce childhood obesity.
Dr. Joseph Skelton, Pediatric Gastroenterology and Nutrition, Department of Pediatrics,
Wake Forest University School of Medicine, gave an in-depth presentation on the epidemic
of childhood obesity. He covered obesity trends since 1998 which indicate that nearly a third
of children ages 10-17 years are overweight or obese. Dr. Skelton explained what it means
to be overweight or obese and the causes of this epidemic. He cited the epidemic's major
culprits are: increased serving sizes, sweetened beverages, and decreased activity levels. Dr.
Skelton concluded his presentation with recommendations for decreasing the number of
children who are overweight or obese. Some of the recommendations included behavioral
therapy, and other child and family based approaches to changing behavior and habits.
Ms. Ellen Essick, School Health Consultant, NC Department of Public Instruction (DPI),
presented an overview of the new Healthful Living Essential Standards which are included in
the new Standard Course of Study for NC traditional public schools. The Healthful Living
Essential Standards include learning benchmarks for kindergarten through 12th grade in
mental and emotional health, personal and consumer health, interpersonal communication
and relationships, nutrition and physical activity, and alcohol, tobacco and other drugs.
Ms. Paula Hudson Hildebrand, Chief Health and Community Relations Officer, Department
of Public Instruction, provided an update of implementation of S.L. 2010-161 (HB 1757),
Fitness Testing in Schools. She shared a document, Fitness Testing Guidelines, which has
been adopted by the State Board of Education and is being implemented for the first time
during the current school year, as directed in the Session Law.
Ms. Hildebrand continued her presentation by describing the State Board of Education
policy on Healthy Active Children (GCS-S-000). The policy encourages elementary schools
to provide 150 minutes per week of physical education (PE) provided by a certified PE
teacher and middle schools to provide 225 minutes per week of Healthful Living Education
provided by a certified health and PE teacher. The policy requires schools to provide a
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minimum of 30 minutes of “moderate to vigorous physical activity” daily to all K-8 students.
This time is supposed to compliment, not supplant, PE. The policy requires each school
system to have a School Health Advisory Council, a coordinated school health program, and
to prepare and submit to DPI annual reports on minutes of physical activity and PE received
by each student. Ms. Hildebrand offered to present 2010-2011 findings of the annual report
at a future Committee meeting.
Ms. Judy Marino, Assistant Director of the In-school Prevention of Obesity and Disease
(IsPOD) program provided an overview of IsPOD’s goals and objectives including assessing
and improving K-8 students’ overall fitness. IsPOD trains teachers to administer the
FITNESSGRAM and to implement the SPARK fitness curriculum. IsPOD also surveys
students and teachers twice per year regarding attitudes, behaviors and fitness levels.
Ms. Lori Rhew, Physical Activity Unit Manager, Physical Activity and Nutrition (PAN)
Branch, Division of Public Health (DPH), Department of Health and Human Services
(DHHS) described the PAN Branch’s mission, goals and activities to decrease childhood
obesity and related chronic diseases. The PAN Branch is collaborating with the Department
of Public Instruction and with the Division of Child Development and Early Education to
help children choose to be involved in physical activity on a daily basis.
Ms. Alice Lenihan, Branch Head of the Nutrition Services Branch, DPH, DHHS, detailed
outdoor time and physical activity requirements for infants, toddlers, and preschoolers
attending licensed child care facilities. She also talked about the limited amount of “screen
time” that is allowed and the Kids Eat Smart Move More program.
Ms. Wendi Boggess, Family Relations Specialist, First Environments Early Learning Center,
shared a Power Point presentation showing photos of children at her child care center
engaged in Kids Eat Smart Move More activities.
Dr. Michael Kanters, Associate Professor, Department of Parks, Department of Parks,
Recreation & Tourism Management, North Carolina State University, recommended that the
State Board of Education policy on interscholastic sports in grades 7-12 be changed to
include 6th graders. Dr. Kanters also mentioned that children who participate in sports are
more active than children who don’t participate in sports.
December 8, 2011
Ms. Jani Kozlowski, Policy Unit Manager, Division of Child Development and Early
Education (DCDEE), described the new nutrition rules that the Child Care Commission had
agreed upon on September 27, 2011. These rules are the result of S.L. 2010-117(HB 1726).
Original rules to help reduce childhood obesity had been developed in August, 2010.
Ms. Alice Lenihan, Branch Head of the Nutrition Services Branch, DPH, DHHS, described
the process of public hearings that had been used to gather input on the new nutrition
standards. They also learned about what different localities are doing to help preschool
children to be more active and to eat more healthy foods. Their Branch plans to work
collaboratively with DCDEE to implement new nutrition standards.
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Dr. Lynn Harvey, Section Chief, Child Nutrition Services, Department of Public Instruction,
presented a thorough overview of Federal Child Nutrition programs offered in each local
school administrative unit (LEA) and administered by DPI. She provided the history of the
program along with current successes and challenges. Overall program costs are increasing
and revenues are decreasing. Dr. Harvey concluded her presentation with information on
food insecurity, or lack of nutritious food, which is being experienced by many children in
North Carolina.
Dr. Carol Ripple, Principal Evaluator, Program Evaluation Division (PED), North Carolina
General Assembly, gave a report on a study that the PED had completed on NC’s Child
Nutrition program. The major findings of that study included (i) program viability depends
on a delicate balance of cost, nutritional value, and student participation; (ii) indirect costs
challenge program solvency; and, (iii) NC does not supplement federal funding beyond the
required match. The PED recommended that programs must be solvent, defined as having
one month’s operating balance, before LEAs can charge indirect costs and that the
legislature should support the NC Procurement Alliance. The Procurement Alliance helps
LEAs to buy food and products in bulk, and thus at lower rates.
Dr. Alice Ammerman, Professor, UNC-Chapel Hill School of Public Health, presented
information about a project that the School of Public Health is engaged in. This project
promotes the creation and consumption of healthy foods at local events such as barbecue
festivals. She also recommended supporting the Sustainable Local Food Advisory Council’s
report to increase the availability of locally-produced foods for SNAP participants.
January 12, 2012
Mr. David Locklear, Assistant Chief, Economic and Family Services, DHHS, explained
eligibility criteria for, and allowable benefits of, the Supplemental Nutrition Assistance
Program (SNAP), formerly called “food stamps.”
Ms. Veronica Bryant, SNAP-Ed Outreach Coordinator, DHHS, explained what this
program does. SNAP-Ed provides nutrition training and information to families who
participate in SNAP to support them to make health food choices. SNAP-Ed also provides
information on increasing SNAP participant physical activity as needed. Ms. Bryant provided
a list of agencies who offer SNAP-Ed and a list of counties served by the agencies. She
concluded her presentation with a description of SNAP-Ed partnerships and pilot projects
including the NC Farmers Markets.
Mr. Gary Gay from the Food Distribution Division in the Department of Agriculture and
Consumer Service explained how the Farm to School program works. He provided
information on what crops are available for schools to purchase during different times of the
year. The NC Farm to School Program served approximately one million students and
delivered over 1 million pounds of NC produce in 2010-11. He indicated that the major
barriers to schools participating in the Farm to School program include lack of refrigeration
space, staff to prepare fresh produce, and Good Agricultural Practices (GAP) certified
farmers.
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Ms. Laurie Stradley, the NC State Lead for the National Farm to School Network provided
evidence that buying local foods is beneficial for health and economic reasons. She
indicated that the components of a farm to school program includes more than just delivery
of fresh produce, but also includes field trips to farms, nutrition education and cooking in
schools, and school gardens. Ms. Stradley concluded her presentation to with several
recommendations to increase the number of schools and farms participating in the farm to
school program.
Ms. Joy Hicks, Policy Development Analyst, Department of Agriculture and Consumer
Services, gave the report form the NC Sustainable Local Food Advisory Council. In 2009,
the General Assembly established the NC Sustainable Local Food Advisory Council. Article
70 of Chapter 106 of the North Carolina General Statutes creates, and provides the duties
of, the Council but the Council is currently set to expire on July 31, 2012. In the Council's
2010 report, some of the recommendations related to reducing childhood obesity included
supporting the Farm-to-School program, expanding SNAP-Ed, supporting WIC and EBT
programs, increasing funding for school cafeterias, increasing local food purchases with
SNAP, and getting whole farms to be GAP certified. The NC Sustainable Local Food
Advisory Council is set to expire in 2012, but would like to have the expiration date
amended so that they can continue to pursue some of the efforts they have begun.
February 15, 2012
Mr. Ronnie Wynne and Ms. Brooke Stephenson from the Marketing Division of the NC
Department of Agriculture and Consumer Services provided an overview of how farms
become GAP certified. GAP stands for Good Agricultural Practices and the certification
process involves farms meeting a number of criteria and food safety procedures. Farms and
packaging facilities are inspected and farm workers are observed and interviewed. GAP
certification is voluntary and the type of certification is driven by the consumer of the
farmer’s products. The certification is used for safety, sanitation, and for marketing, e.g., a
restaurant who advertises local produce from a GAP certified farm.
Ms. Heather Barnes, Marketing Director, NC Farm to School Program, indicated that DPI
requires farms to be GAP certified before a school can buy produce from them.
Mr. Roland McReynolds, Carolina Farm Stewardship Association, further explained the
GAP certification process, and the positive reasons for having the certification, but also the
hardships placed on farmers going through this process. His group, working with the NC
Fresh Produce Safety Task Force, found that the current GAP certification process is not
well-suited for small-scale farms. They are developing an All-Farm GAP process pilot
project to see if this alternative would be less costly and easier for small farms to complete.
The project will produce a results report and guidance manual later this year.
Ms. Paula Hudson Hildebrand, Chief Health and Community Relations Officer, DPI, gave
the 2010-2011 Health Active Children Policy Report. According to data submitted to DPI
by 95% of LEAs, 51% provide 150 minutes of weekly physical education (PE) with PE
certified teachers to elementary school children and 52% proved 225 minutes of weekly
Healthful Living coursework with certified health and PE teachers. She indicated that cost of
certified teachers in these areas and equipment was hindering other school systems to meet
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these aspects of the Healthy Active Children Policy. Ms. Hildebrand included in her report
the successes of the local school health advisory councils including a significant reduction in
the use of exercise in schools as a punishment.
Representative LaRoque passed out a current report from the IsPOD which indicated that
teachers and students report less involvement in physical education and activity. Ms. Judy
Marino from IsPod and Ms. Hildebrand from DPI indicated that teacher and student
perceptions from their individuals schools and life experiences may be different from the
reports sent to DPI which reflect physical education and activity on the whole across an
LEA.
Ms. Pamela Smith, Child Nutrition Director, Lenoir County Schools, provided a local
perspective on running a child nutrition program. She talked about how Lenoir County
Schools had been running a significant deficit until they ended 25 positions through attrition,
reduced the variety of items on the menu, and participated in the NC Procurement Alliance.
Their Child Nutrition Program now does not pay indirect costs. She talked about
introducing more fresh fruits and vegetables to all children who come through the cafeteria
lines and that fresh salads had actually become a popular item with all of the children. She
concluded her presentation with a description of how cashiers have to charge children based
on different elements required by the USDA and how Lenoir County Schools uses
lunchprepay.com that allows families to keep funds available for their child to use and know
what foods their child purchases.
Dr. Patrick Miller, Superintendent, Greene County Schools, shared their “success story” in
being able to meet the State Board of Education’s Healthy Active Children policy. He said
that they had prioritized their small system and low wealth system funds to hire certified PE
teachers in each of their schools in 2006-2007. He said that they had seen a decrease in
behavior referrals since being able to offer PE and/or “energizers” to all of their students on
a daily basis.
Ms. Angie Miller, Healthful Living Coordinator, Nash-Rocky Mount Public Schools,
presented their “success story” as they had also been able to meet the State Board of
Education (SBE) policy of providing daily physical activity. Her school system partnered
with the local hospital and YMCA to offer incentives such as water bottles and jump ropes
to children when they walked a number of miles. Each student walks a targeted amount per
day with their teacher in this school system.
Dr. Lynn Harvey concluded this meeting by presenting the new federal nutrition standards
which were mandated on January 26, 2012 with passage of the final rule on meal pattern and
nutrition standards. Dr. Harvey explained the differences in the amounts of each component
required by the USDA. More fruits, vegetables, and whole grains will be required. Reduced
sodium, calories, and trans fat will also be required. The cost estimate of implementing the
new nutrition standards is an estimated 10 cents for each lunch and 27 cents for each
breakfast. The final rule states that “school districts will be required to make a substantial
investment to improve the quality of school meals.” As such, Dr. Harvey indicated that
State and local governments will likely be expected to play a significant role in coming up
with the funding for improved nutrition standards. Additionally, Dr. Harvey highlighted
barriers to an optimal nutrition environment which supports obesity prevention including:
14
inadequate funds; nutrition not valued as part of the instructional day; priority for the child
nutrition program to be financially self-supporting; limited time and or space for students to
eat meals at school; too little nutrition education; and student taste preferences. There will
be a gradual implementation of the new nutrition standards over the next three years.
April 25, 2012
The chair recognized Committee staff to go through the draft Committee report and the
draft recommendations and corresponding bill drafts. Theresa Matula provided information
on the Committee's purpose and reporting requirements as contained in the Committee
authorization. Ms. Matula reviewed the elements of the report and explained the first four
draft recommendations and corresponding bill drafts. Sara Kamprath explained the
remaining seven draft recommendations and corresponding bill drafts. After each draft
recommendation and bill draft was explained by staff, the Committee discussed the
recommendation and bill draft making any changes deemed appropriate. The Committee
voted to approve each draft recommendation and corresponding bill draft.
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FINDINGS AND RECOMMENDATIONS
Improving Child Nutrition Programs
Recommendation 1: The House Select Committee on Childhood Obesity
recommends that the General Assembly appropriate:
 $20 million dollars for the 2012-13 fiscal year to the Department of Public
Instruction to assist child nutrition programs in meeting nutrition standards.
and
 $1.7 million dollars for the 2012-13 fiscal year to the Department of Public
Instruction to support the elimination of the student cost of the reduced-price
breakfast in order to increase the participation rate.
and
 funds for the 2012-13 fiscal year to the Department of Public Instruction to
support the cost of any increases in salaries and benefits required by the State
for child nutrition personnel.
These recommendations are contained in bill drafts 2011-SHza-12, 2011-SHza-13,
and 2011-SHza-14.
Background 1: The Program Evaluation Division report on December 8, 2011, indicated
that 32 states supplement federal child nutrition funds. Some states have a recurring flat
appropriation amount, some fund labor costs, and some provide meal reimbursements. The
Department of Public Instruction indicated that since 2007, the State Board of Education
has requested $20 million annually to assist Child Nutrition programs in meeting nutrition
standards. Following the Committee’s March meeting, the Department of Public Instruction
provided supplemental information indicating a cost of $1.7 million dollars to eliminate the
student cost of a reduced-price breakfast for children who qualify for reduced-price meals.
Recommendation 2: The House Select Committee on Childhood Obesity
recommends that the General Assembly require the Department of Public
Instruction to work with school districts to decrease food costs and increase the use
of locally grown fresh fruits and vegetables through 1) increased participation in the
North Carolina Procurement Alliance and 2) increased participation in the Farm to
School program, and to report progress on this recommendation on or before
November 1, 2013, to the Joint Legislative Education Oversight Committee. To
support these initiatives the House Select Committee on Childhood Obesity
recommends that the General Assembly appropriate $80,000 for the 2012-13 fiscal
year to the Department of Public Instruction to provide administrative support for
the NC Procurement Alliance; and to appropriate $5,000 to the Department of Public
Instruction for each school district, for a total of $575,000 for the 2012-13 fiscal year,
to purchase chopping/slicing devices, or other equipment, that would encourage the
purchase and consumption of locally grown fresh fruits and vegetables in school food
services.
This recommendation is contained in bill draft 2011-TLza-17.
16
Background 2: The Program Evaluation Division report on December 8, 2011, presented
information on opportunities for child nutrition programs to save money when purchasing
food and supplies through the North Carolina Procurement Alliance. The Division found
that Members have realized an average savings of 6% on the purchase of food and supplies.
The Division recommended funding administrative support for the Procurement Alliance in
the amount of $80,000.
Following the Committee’s March meeting, the Department of Public Instruction provided
information indicating that 87 school districts currently participate in the Procurement
Alliance. The Department funds a position to support the work of Alliance and the
remaining support is provided through federal grants and the efforts of school district
volunteers. The Department indicated that the funds provided to support the Procurement
Alliance are not sufficient to enable the buying group to operate at an optimal level or to
expand.
During meetings on January 12, 2012, and February 15, 2012, the Committee heard
presentations on the North Carolina Farm to School Program coordinated by the North
Carolina Department of Agriculture. The Farm to School program has been in operation for
15 years. Comments by the Committee members indicated that the purchase of locally
grown produce from farmers and the consumption of this produce by school children was a
win-win situation for North Carolina. However, some concerns were shared with the
Committee that many school kitchens are not equipped to handle the preparation of fresh
fruits and vegetables for consumption by children.
Following the Committee’s March meeting, the Department of Public Instruction provided
information on the need for funding to support the purchase of equipment that supports the
use of fresh, locally-grown produce. Within the last several years, districts did receive some
federal funding for equipment purchases. However the equipment requests received totaled
$12.5 million, but the funding received was only $3.2 million. Equipment needs include:
pass-through refrigerators, refrigerated display cases, chopping/slicing devices, and walk-in
coolers. The Department indicated that a vertical cutter mixer would cost approximately
$5,000 and could facilitate the use of fresh produce.
Recommendation 3: The House Select Committee on Childhood Obesity
recommends that the General Assembly amend G.S. 143-64 to remove “local school
administrative units” which is anticipated to save $500,000 by removing the
requirement that school districts procure juice and water separately from other foods
and beverages.
This recommendation is contained in bill draft 2011-SHz-15.
Background 3: Following the Committee’s March meeting, the Department of Public
Instruction provided information indicating that G.S. 143-64 requires local school
administrative units to competitively bid contracts for the sale of bottled water separately
from each other and separately from any other contract. The Department reported that this
requires school districts to procure juice and water separately from each other and from all
other foods and beverages served in the school breakfast and lunch program and the
approximate cost of this administrative burden exceeds $500,000. The Department reported
that all purchases of foods and beverages in the child nutrition program are made in
17
compliance with federal regulations. An amended version of G.S. 143-64 has been provided
below.
§ 143-64. Beverages contracts.
Notwithstanding any other provision of law, local school administrative units,
community colleges, and constituent institutions Notwithstanding any other provision of
the law, community colleges and constituent institutions of The University of North
Carolina shall competitively bid contracts that involve the sale of juice or bottled water.
Contracts for the sale of juice and contracts for the sale of bottled water shall each be
bid separately from each other and separately from any other contract, including
contracts for other beverages or vending machine services. The local school
administrative units, community colleges, Community Colleges and constituent
institutions may set quality standards for these beverages, and these standards may be
used to accept or reject a bid.
Recommendation 4: The House Select Committee on Childhood Obesity
recommends that the General Assembly require the State Board of Education and
the Department of Public Instruction to determine the optimal amount of seat time
students need for breakfast and lunch and to explore innovative options for utilizing
meal time as instructional time and to report on or before January 1, 2014, to the Joint
Legislative Education Oversight Committee.
This recommendation is contained in bill draft 2011-TLz-18.
Background 4: On December 8, 2011, Child Nutrition Services reported the following
breakfast participation levels: 37% in Elementary School, 19% in Middle School, 12% in
High School. The following lunch participation levels were reported: 77% in Elementary
School, 69% in Middle School, 42% in High School. According to information presented by
the Department of Public Instruction, North Carolina has the tenth most food insecure
student body in the nation and the fifth fattest student body in the nation. For some
students a school breakfast and/or lunch may provide a significant portion of their daily
food intake. Many studies have shown a link between decreased instructional outcomes
when children are hungry. The Committee expressed concerns that all school students may
not have adequate time to go through the cafeteria line and to eat breakfast and lunch.
However, it is not clear how much time is appropriate. The Committee also expressed an
awareness of the importance of instructional time. The Department mentioned several
options that included “grab and go” meals and other options which may include facilitating
students eating breakfast in the classroom. A study would explore both the optimal seat
time and innovative approaches to ensuring students have the opportunity to eat breakfast
and lunch.
Increasing the Consumption of Healthy Food in Communities
Recommendation 5: The House Select Committee on Childhood Obesity
recommends that the General Assembly require the Department of Health and
Human Services to increase participation in Supplemental Nutrition Assistance
Program Education (SNAP-Ed) and to report progress on or before October 1, 2013,
to the Joint Legislative Oversight Committee on Health and Human Services.
This recommendation is contained in bill draft 2011-TLz-19.
18
Background 5: On January 12, 2012, the Division of Social Services, Department of Health
and Human Services, presented information on Food and Nutrition Services and
Supplemental Nutrition Assistance Program Education (SNAP-Ed). SNAP-Ed is an
optional nutrition education and obesity prevention grant program that is 100% federally
funded. The Division provided that the goals of SNAP-Ed include: healthy food choices
within a limited budget, physically active lifestyles, and education on Dietary Guidelines for
Americans and MyPlate. The focus of the program is to encourage consumption of fruits,
vegetables, whole grains, and fat free or low-fat milk instead of unhealthy alternatives. The
program also encourages physical activity, caloric intake monitoring and drinking water
instead of sugary drinks.
Recommendation 6: The House Select Committee on Childhood Obesity appreciates
and supports efforts to assist farmers in becoming Good Agricultural Practices (GAP)
certified in order to increase participation in the Farm to School program and to
increase the availability, supply and consumption of healthy locally grown fruits and
vegetables.
No legislation is necessary for this recommendation.
Background 6: During the meetings on January 12, 2012 and February 15, 2012, the
Committee heard presentations on the Farm to School program and Good Agricultural
Practices (GAP) certification for farmers. The Committee appreciates current and future
efforts by the Department of Agriculture and the Carolina Farm Stewardship Association to
assist farmers in obtaining GAP certification thereby increasing local farmer participation in
the Farm to School program and public access to healthy fruits and vegetables.
Recommendation 7: The House Select Committee on Childhood Obesity
recommends that the General Assembly require the Department of Health and
Human Services, the Department of Agriculture & Consumer Services to work
toward increasing the number of farmers markets accepting SNAP (Supplemental
Nutrition Assistance Program) EBT (Electronic Benefit Transfer) cards, to make the
location of these markets known to SNAP recipients, and to report progress on this
recommendation on or before March 1, 2013 and November 1, 2013, to the Joint
Legislative Oversight Committee on Health and Human Services.
This recommendation is contained in bill draft 2011-TLz-19.
Background 7: During the January 12, 2012 meeting the Committee heard a presentation
on SNAP and SNAP-Ed. At the December 8, 2011 meeting, the Committee heard from Dr.
Alice Ammerman, Professor, Department of Nutrition, Gillings School of Global Public
Health and School of Medicine Director, Center for Health Promotion and Disease
Prevention, University of North Carolina at Chapel Hill, who presented information on
SNAP-Ed and the economic case for local food. Dr. Ammerman presented
Recommendation 13 from the Sustainable Local Food Advisory Council's 2011 report,
which encouraged the SNAP-Ed Advisory Committee to work with the Council's
subcommittee to consider a statewide coordinated approach to encourage the use of locally
produced food by SNAP participants. The Committee is encouraged by the work thus far to
increase the acceptance of SNAP EBT cards at farmers markets. Increasing acceptance of
these cards will assist farmers and SNAP recipients by increasing consumption of locally
grown fruits and vegetables.
19
Recommendation 8: The House Select Committee on Childhood Obesity
recommends that the General Assembly continue the Sustainable Local Food
Advisory Council until July 31, 2015.
This recommendation is contained in bill draft 2011-TLz-20.
Background 8: Session Law 2009-530 created the North Carolina Sustainable Local Food
Advisory Council to address program and policy considerations regarding the development
of a sustainable local food economy in North Carolina. The Council is set to expire on July
31, 2012. The Committee has heard from a number of groups that are involved with the
Council and has benefited from information facilitated through the Council. The Council
has requested continuation.
Increasing Physical Activity Among Children
Recommendation 9: The House Select Committee on Childhood Obesity
recommends that the General Assembly establish the Task Force on Physical
Education and Physical Activity in Schools (Task Force) to examine strategies for
increasing physical activity and quality physical education instruction in the public
schools. In the course of the study, the Task Force shall consider and recommend
to the General Assembly a strategic plan to:
 Increase the amount of time that K-8 students are engaged in daily moderate
to vigorous physical activity.
 Increase the number of K-8 students that are receiving the amount of weekly
physical education recommended by the State Board of Education.
 Provide adequate facilities, equipment, and licensed physical education
instructors.
 Identify local and statewide funding sources, including potential public-private
partnerships.
 Identify methods to provide and fund the collection of reliable data from
fitness testing that can be used to monitor and improve student health.
The Task Force shall consider any recommendations that are received from the State
Board of Education work group on fitness testing data and use. The Task Force
shall also identify any other barriers to increasing physical activity and quality
physical education instruction in the public schools and recommend any means to
overcome those barriers. The Task Force shall include members of the North
Carolina Senate and House of Representatives; representatives from the Department
of Public Instruction; the Division of Public Health in the Department of Health and
Human Services; and other interested stakeholders. The Task Force shall report
interim progress on this recommendation on or before March 1, 2013 and shall
provide a final report on or before March 15, 2014 to the Joint Legislative Education
Oversight Committee.
This recommendation is contained in bill draft 2011-RJz-4.
Background 9: At the November 10 meeting, the Committee heard about the link between
the amount of time that a child participated in daily activity and the child's grades in school.
According to the Physical Activity and Nutrition Branch of DHHS, parents reported that
20
53% of children who spent over an hour in physical activity each day made mostly A's as
compared to 42% of children who spent less than 20 minutes in physical activity each day
made mostly A's.
Paula Hudson Hildebrand, Chief Health and Community Relations Officer for DPI,
explained State Board of Education Policy HSP-S-000 that required schools to provide daily
a minimum of 30 minutes of moderate to vigorous physical activity to all K-8 students. The
requirement can be met through a regular physical education class or through other activities
such as recess, dance, classroom energizers, or other curriculum based physical education
activity programs. This time should not substitute for the physical education program.
During the February 15, 2012 meeting, Ms. Hildebrand provided the results of a 2011 study
on the percentage of local school administrative units (LEAs) that are meeting the
requirements of this policy. DPI combined city and county LEAs for the purposes of this
report and 106/112 (combined LEAs) provided data. Slightly over half (51%) of the
reporting LEAs indicated that all of their elementary schools are meeting the suggested 150
minutes per week with a certified Physical Education teacher. Slightly over half (52%) of the
reporting LEAs indicate that all of their middle schools are meeting the suggested 225
minutes per week of Healthful Living instruction taught by a certified Health and Physical
Education teacher. Therefore, it appears that only about half of the State's school children
are being provided with physical education by a certified PE teacher.
During the November 10th meeting, Dr. Michael Kanters, Associate Professor, Department
of Parks, Recreation & Tourism Management, NCSU, spoke on the importance of providing
intramural opportunities for students who do not participate in interscholastic athletic
competition. Dr. Kanters mentioned that children who participate in sports are more active
than children who don’t participate in sports. He pointed out that his research found that
about 32,000 6th graders don’t have access to any school sports. Dr. Kanters mentioned that
this is important because when children don’t participate in sports their motivation to
participate later diminishes. His research found that intramural sports attract more students
than interscholastic sports and that African American and low-income students are more
likely to participate in sports in schools that have intramural sports programs. Dr. Kanters
presented research indicating that 47% of schools offer some type of intramurals but that
sometimes facilities sit empty but intramurals more effectively use buildings.
Recommendation 10: The House Select Committee on Childhood Obesity
recommends that the General Assembly direct the State Board of Education to
coordinate a work group to examine how to continue the collection of data from
fitness testing currently conducted in the public schools, methods to ensure that the
data is reliable, procedures to allow the data to be shared appropriately with State
agencies in order to have a Statewide picture of fitness levels of students, and
funding sources for these activities. The work group should include representatives
from the Department of Public Instruction; the NC Alliance for Athletics, Health,
Physical Education, Recreation, and Dance; the Division of Public Health in the
Department of Health and Human Services; the American Heart Association; and
other organizations and agencies deemed appropriate. The work group shall report
to the Task Force on Physical Education and Physical Activity in Schools by June 30,
2013 on the results of its work.
This recommendation is contained in bill draft 2011-RJz-4.
21
Background 10: At the November 10 meeting, Paula Hudson Hildebrand, Chief Health
and Community Relations Officer for DPI, explained about the new fitness testing
guidelines for K-8 students developed by the State Board of Education as required by
Session Law 2010-61. The new tests should measure aerobic capacity, body composition,
muscular strength, muscular, endurance and flexibility. At the same meeting, the Committee
heard that the Kate B. Reynolds grant funding that supports the efforts of the NC Alliance
for Athletics, Health, Physical Education, Recreation, and Dance (NC AAHPERD) will end
on July 31, 2012. Through the grant NCAAHPERD has collected data on the fitness levels
of K-8 students.
Following the Committee’s March meeting, the State Board and DPI provided information
that DPI had lead the task force that initially developed the new fitness testing guidelines
and would be the logical entity to lead this new task force.
Addressing Early Childhood Obesity
Recommendation 11: The House Select Committee on Childhood Obesity
recommends that the North Carolina Institute of Medicine (NCIOM) present the
findings and recommendations of the NCIOM Task Force on Early Childhood
Obesity Prevention to the Joint Legislative Education Oversight Committee when
those findings are available in 2013.
No legislation is necessary for this recommendation.
Background 11: The North Carolina Institute of Medicine (NCIOM) Task Force on Early
Childhood Obesity Prevention is working to develop recommendations to address barriers
and to ensure the availability of systems and services to improve young children, ages 0-5,
and the physical and nutritional health of their families. According to information from the
NCIOM, the Task Force is charged to:
(1) examine evidence-based and promising practices from prior North Carolina
related task forces, as well as from the White House and national Institute of
Medicine Committee on Childhood Obesity Prevention; and
(2) develop a strategic plan to prevent or reduce early childhood obesity in North
Carolina that can serve as a blueprint for foundations, government, health
professional associations, and other community groups interested in improving
the health of young children, ages 0-5
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HOUSE SELECT COMMITTEE ON
CHILDHOOD OBESITY
REPORT TO THE 2012
REGULAR SESSION
OF THE 2011
GENERAL ASSEMBLY
NORTH C AROL INA G ENE R A L A S S E M B LY
A LIMITED NUMBER OF COPIES OF THIS REPORT IS AVAILABLE
FOR DISTRIBUTION THROUGH THE LEGISLATIVE LIBRARY.
ROOMS 2126, 2226
STATE LEGISLATIVE BUILDING
RALEIGH, NORTH CAROLINA 27611
TELEPHONE: (919) 733-7778
OR
ROOM 500
LEGISLATIVE OFFICE BUILDING
RALEIGH, NORTH CAROLINA 27603-5925
TELEPHONE: (919) 733-9390
TABLE OF CONTENTS
LETTER OF TRANSMITTAL .......................................................................................................................... 1
COMMITTEE MEMBERSHIP ......................................................................................................................... 2
AUTHORIZING LEGISLATION. .................................................................................................................. 4
OVERVIEW OF COMMITTEE PRESENTATIONS ................................................................................. 6
SUMMARY OF COMMITTEE PROCEEDINGS ........................................................................................ 9
COMMITTEE FINDINGS AND RECOMMENDATIONS ..................................................................... 15
LEGISLATIVE PROPOSAL I – AN ACT TO APPROPRIATE FUNDS TO THE
DEPARTMENT OF PUBLIC INSTRUCTION FOR THE CHILD NUTRITION
PROGRAM TO ASSIST CHILD NUTRITION PROGRAMS IN MEETING
NUTRITION STANDARDS, AS RECOMMENDED BY THE HOUSE SELECT
COMMITTEE ON CHILDHOOD OBESITY. ............................................................................................. 22
LEGISLATIVE PROPOSAL II – AN ACT TO APPROPRIATE FUNDS TO THE
DEPARTMENT OF PUBLIC INSTRUCTION FOR THE CHILD NUTRITION
PROGRAM TO ELIMINATE THE STUDENT COST FOR REDUCED-PRICE
BREAKFAST IN ORDER TO INCREASE BREAKFAST PARTICIPATION, AS
RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON CHILDHOOD
OBESITY ............................................................................................................................................................... 23
LEGISLATIVE PROPOSAL III – AN ACT TO APPROPRIATE FUNDS TO THE
DEPARTMENT OF PUBLIC INSTRUCTION TO OFFSET THE COST OF SALARY
AND BENEFIT INCREASES REQUIRED BY THE STATE FOR CHILD
NUTRITION PERSONNEL IN LOCAL SCHOOL ADMINISTRATIVE UNITS, AS
RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON CHILDHOOD
OBESITY ............................................................................................................................................................... 24
LEGISLATIVE PROPOSAL IV – AN ACT TO REDUCE CHILD NUTRITION
PROGRAM FOOD COSTS BY ENCOURAGING PARTICIPATION IN THE NORTH
CAROLINA PROCUREMENT ALLIANCE AND BY APPROPRIATING FUNDS FOR
ADMINISTRATIVE SUPPORT FOR THE PROCUREMENT ALLIANCE; AND
ENCOURAGING USE OF THE FARM TO SCHOOL PROGRAM AND BY
APPROPRIATING FUNDS FOR CHILD NUTRITION EQUIPMENT TO
ENCOURAGE CONSUMPTION OF LOCALLY GROWN FRUITS AND
VEGETABLES, AS RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON
CHILDHOOD OBESITY ................................................................................................................................. 25
LEGISLATIVE PROPOSAL V – AN ACT TO SAVE MONEY BY REMOVING
LOCAL SCHOOL ADMINISTRATIVE UNITS FROM THE SEPARATE BID
REQUIREMENTS FOR JUICE AND WATER, AS RECOMMENDED BY THE
HOUSE SELECT COMMITTEE ON CHILDHOOD OBESITY ........................................................... 27
LEGISLATIVE PROPOSAL VI – AN ACT TO DIRECT THE STATE BOARD OF
EDUCATION AND THE DEPARTMENT OF PUBLIC INSTRUCTION TO
DETERMINE OPTIMAL SEAT TIME FOR STUDENTS EATING MEALS IN
PUBLIC SCHOOLS AND TO EXPLORE MEAL TIME OPTIONS, AS
RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON CHILDHOOD
OBESITY ............................................................................................................................................................... 28
LEGISLATIVE PROPOSAL VII – AN ACT TO WORK TOWARD DECREASING
OBESITY IN SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)
PARTICIPANTS BY INCREASING THEIR PARTICIPATION IN SUPPLEMENTAL
NUTRITION ASSISTANCE PROGRAM EDUCATION (SNAP-ED) AND MAKING
FRESH, LOCALLY GROWN PRODUCE AVAILABLE BY INCREASING THE
ACCEPTANCE OF ELECTRONIC BENEFITS TRANSFER (EBT) CARDS AT
FARMERS MARKETS, AS RECOMMENDED BY THE HOUSE SELECT
COMMITTEE ON CHILDHOOD OBESITY .............................................................................................. 29
LEGISLATIVE PROPOSAL VIII – AN ACT TO CONTINUE THE WORK OF THE
SUSTAINABLE LOCAL FOOD ADVISORY COUNCIL, AS RECOMMENDED BY
THE HOUSE SELECT COMMITTEE ON CHILDHOOD OBESITY ................................................. 30
LEGISLATIVE PROPOSAL IX – AN ACT TO ESTABLISH THE TASK FORCE ON
PHYSICAL EDUCATION AND PHYSICAL ACTIVITY IN SCHOOLS AND TO
DIRECT THE STATE BOARD OF EDUCATION TO COORDINATE A WORK
GROUP TO EXAMINE THE CURRENT STATUS OF DATA COLLECTION FROM
FITNESS TESTING CONDUCTED IN KINDERGARTEN THROUGH EIGHTH
GRADE, AS RECOMMENDED BY THE HOUSE SELECT COMMITTEE ON
CHILDHOOD OBESITY ................................................................................................................................. 31
1
STATE OF NORTH CAROLINA
HOUSE SELECT COMMITTEE ON CHILDHOOD OBESITY
April 25, 2012
TO THE MEMBERS OF THE 2012 REGULAR SESSION OF THE 2011 GENERAL
ASSEMBLY:
Attached for your consideration is the report to the 2012 Regular Session of the 2011
General Assembly. This report was prepared by the House Select Committee on Childhood
Obesity pursuant to G.S. 120-19.6(a1) and Rule 26 of the Rules of the House of
Representatives of the 2011 General Assembly.
Respectfully submitted,
____________________________ ____________________________
Representative Stephen LaRoque Representative Norman Sanderson
Cochair Cochair
2
COMMITTEE MEMBERSHIP
House Select Committee on Childhood Obesity
Rep. Stephen LaRoque, Chair Rep. Norman Sanderson, Chair
P. O. Box 1034 269 Bennett Rd. #4
Kinston, NC 28503 Arapahoe, NC 28510
Stephen.LaRoque@ncleg.net Norman.Sanderson@ncleg.net
Office: (252)523-7700 Office: (252) 249-3749
Cell: (252) 560-3399 Cell:
Rep. Marcus Brandon Rep. Larry Brown
200 Oak St., Apt. 3 P.O. Box 85
High Point, NC 27260 Kernersville, NC 27285
Marcus.Brandon@ncleg.net Larry.Brown@ncleg.net
Office: (336) 987-3357 Office: (336) 972-4256
Cell: Cell:
Rep. Rayne Brown Rep. Verla Insko
416 Lee Ave. 610 Surry Rd.
Lexington, NC 27295 Chapel Hill, NC 27514
Rayne.Brown@ncleg.net Verla.Insko@ncleg.net
Office: (336) 249-2608 Office:
Cell: Cell:
Rep. Linda Johnson Rep. Chuck McGrady
1205 Berkshire Dr P. O. Box 723
Kannapolis, NC 28081 Hendersonville, NC 28793
Linda.Johnson2@ncleg.net Chuck.McGrady@ncleg.net
Office: (704) 932-1376 Office: (828) 692-3696
Cell: Cell:
Rep. Garland Pierce
21981 Buie St.
Wagram, NC 28396
Garland.Pierce@ncleg.net
Office: (910) 369-2844
Cell:
3
Staff
Sara Kamprath, Research Division
Patsy Pierce, Research Division
Theresa Matula, Research Division
Dee Atkinson, Research Division
Lisa Wilks, Bill Drafting Division
Lisa Hollowell, Fiscal Research Division
Denise Thomas, Fiscal Research Division
Committee Clerks
Lisa Kennedy
Kathy Voss
AUTHORI Z IN
4
NG LEGISLATION
5
6
OVERVIEW OF COMMITTEE
PRESENTATIONS
The House Select Committee on Childhood Obesity met 5 times from November 10,
2011 until April 25, 2012.
November 10, 2011
Committee Authorization/Budget
Sara Kamprath, Committee Staff
Enacted Legislation Related to Childhood Obesity (2008-2011)
Theresa Matula, Committee Staff
Overview of the Problem of Childhood Obesity in North Carolina
Dr. Joseph Skelton, MD, Section of Pediatric Gastroenterology and Nutrition
Department of Pediatrics, Wake Forest University School of Medicine
Department of Public Instruction Activities
Healthful Living Essential Standards
Ellen Essick, Coordinated School Health Consultant
NC Healthy Schools, DPI
Healthy Active Children Policy
State Board of Education Policy Regarding Physical Activity in the Public Schools
Paula Hudson Hildebrand, Chief Health and Community Relations Officer, DPI
Fitness Testing Guidelines: Implementation of HB 1757
Paula Hudson Hildebrand, Chief Health and Community Relations Officer, DPI
IsPOD (In-School Prevention of Obesity and Disease)
Judy Martino, Assistant Executive Director for Grants & Special Programs, NCAAHPERD
Physical Activity Initiatives for Early Childhood Programs
Lori Rhew, MA, PAPHS, Physical Activity Unit Manager
Physical Activity and Nutrition Branch
North Carolina Division of Public Health, Department of Health and Human Services
Alice Lenihan, MPH, RD, LDN, Branch Head
Nutrition Services Branch, North Carolina Division of Public Health, Department of Health
and Human Services
Wendi Boggess, Family Relations Specialist
First Environments Early Learning Center
7
Middle School Sport Policies and Sport Participation
Dr. Michael Kanters, Associate Professor
Department of Parks, Recreation & Tourism Management, NCSU
December 8, 2011
S.L. 2010-117 (HB 1726), Improve Childcare Nutrition Standards
Jani Kozlowski, Director's Office, Policy Unit Manager, Division of Child Development and
Early Education
Alice Lenihan, Branch Head, Nutrition Services Branch, Division of Public Health
School Nutrition Program
Lynn Harvey, Section Chief, Child Nutrition Services, DPI
NC General Assembly Program Evaluation Division
Child Nutrition Programs Study Report
Carol Ripple, Principal Evaluator
Fresh and Local Food in Communities
Alice Ammerman, Director, Center for Health Promotion and Disease Prevention, UNC-CH
Professor, Department of Nutrition, Gillings School of Global Public Health and School of
Medicine, UNC-CH
January 12, 2012
Eligibility for Food and Nutrition Services (FNS) Benefits
David Locklear, Assistant Chief, Economic and Family Services Section, Department of
Health and Human Services
SNAP-Ed
Veronica Bryant, SNAP-Ed Outreach Coordinator, Department of Health and Human
Services
North Carolina Farm to School Program
Gary Gay, Food Distribution Division, Department of Agriculture and Consumer Services
National Farm to School Network
Laurie Stradley, State Lead for the National Farm to School Network
North Carolina Sustainable Local Food Advisory Council Recommendations from
2011 Annual Report
Joy Hicks, Policy Development Analyst, Department of Agriculture and Consumer Services
8
February 15, 2012
Good Agricultural Practices (GAP) Certification as it Relates to Farm to School
Heather Barnes, Farm to School, NC Department of Agriculture
Brooke Stephenson, Marketing Division, NC Department of Agriculture
Small Farms and GAPs: Addressing On-the-Ground Challenges
Roland McReynolds, Executive Director, Carolina Farm Stewardship Association
Child Nutrition Issues: A Local Perspective
Pam Smith, Child Nutrition Director, Lenoir County Schools
Healthy Active Children Policy Report
Paula Hudson Hildebrand, Chief Health and Community Relations Officer, DPI
Physical Education Success Stories
Dr. Patrick Miller, Superintendent, Greene County Schools
Angie Miller, Healthful Living Coordinator, Nash-Rocky Mount Public School System
New Federal Child Nutrition Standards and Possible Local Impact
Lynn Harvey, Section Chief, Child Nutrition Services, DPI
April 25, 2012
Committee Report
Review of Draft Report
Committee Discussion
9
COMMITTEE PROCEEDINGS
This section of the report provides a brief summary of the Committee meetings. It is not
intended to be a complete, official record of those meetings. However, there is an official
record of the Committee’s meetings, including minutes and handouts distributed to the
Committee members, in the Legislative Library.
November 10, 2011
Ms. Sara Kamprath, Legislative Analyst, Research Division, General Assembly reviewed the
authorizing legislation and budget for the Committee.
Ms. Theresa Matula, Legislative Analyst, Research Division, General Assembly, reviewed
enacted legislation from 2008 through 2011 related to childhood obesity to give Committee
members context on what has happened and what may still need to be enacted to help to
reduce childhood obesity.
Dr. Joseph Skelton, Pediatric Gastroenterology and Nutrition, Department of Pediatrics,
Wake Forest University School of Medicine, gave an in-depth presentation on the epidemic
of childhood obesity. He covered obesity trends since 1998 which indicate that nearly a third
of children ages 10-17 years are overweight or obese. Dr. Skelton explained what it means
to be overweight or obese and the causes of this epidemic. He cited the epidemic's major
culprits are: increased serving sizes, sweetened beverages, and decreased activity levels. Dr.
Skelton concluded his presentation with recommendations for decreasing the number of
children who are overweight or obese. Some of the recommendations included behavioral
therapy, and other child and family based approaches to changing behavior and habits.
Ms. Ellen Essick, School Health Consultant, NC Department of Public Instruction (DPI),
presented an overview of the new Healthful Living Essential Standards which are included in
the new Standard Course of Study for NC traditional public schools. The Healthful Living
Essential Standards include learning benchmarks for kindergarten through 12th grade in
mental and emotional health, personal and consumer health, interpersonal communication
and relationships, nutrition and physical activity, and alcohol, tobacco and other drugs.
Ms. Paula Hudson Hildebrand, Chief Health and Community Relations Officer, Department
of Public Instruction, provided an update of implementation of S.L. 2010-161 (HB 1757),
Fitness Testing in Schools. She shared a document, Fitness Testing Guidelines, which has
been adopted by the State Board of Education and is being implemented for the first time
during the current school year, as directed in the Session Law.
Ms. Hildebrand continued her presentation by describing the State Board of Education
policy on Healthy Active Children (GCS-S-000). The policy encourages elementary schools
to provide 150 minutes per week of physical education (PE) provided by a certified PE
teacher and middle schools to provide 225 minutes per week of Healthful Living Education
provided by a certified health and PE teacher. The policy requires schools to provide a
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minimum of 30 minutes of “moderate to vigorous physical activity” daily to all K-8 students.
This time is supposed to compliment, not supplant, PE. The policy requires each school
system to have a School Health Advisory Council, a coordinated school health program, and
to prepare and submit to DPI annual reports on minutes of physical activity and PE received
by each student. Ms. Hildebrand offered to present 2010-2011 findings of the annual report
at a future Committee meeting.
Ms. Judy Marino, Assistant Director of the In-school Prevention of Obesity and Disease
(IsPOD) program provided an overview of IsPOD’s goals and objectives including assessing
and improving K-8 students’ overall fitness. IsPOD trains teachers to administer the
FITNESSGRAM and to implement the SPARK fitness curriculum. IsPOD also surveys
students and teachers twice per year regarding attitudes, behaviors and fitness levels.
Ms. Lori Rhew, Physical Activity Unit Manager, Physical Activity and Nutrition (PAN)
Branch, Division of Public Health (DPH), Department of Health and Human Services
(DHHS) described the PAN Branch’s mission, goals and activities to decrease childhood
obesity and related chronic diseases. The PAN Branch is collaborating with the Department
of Public Instruction and with the Division of Child Development and Early Education to
help children choose to be involved in physical activity on a daily basis.
Ms. Alice Lenihan, Branch Head of the Nutrition Services Branch, DPH, DHHS, detailed
outdoor time and physical activity requirements for infants, toddlers, and preschoolers
attending licensed child care facilities. She also talked about the limited amount of “screen
time” that is allowed and the Kids Eat Smart Move More program.
Ms. Wendi Boggess, Family Relations Specialist, First Environments Early Learning Center,
shared a Power Point presentation showing photos of children at her child care center
engaged in Kids Eat Smart Move More activities.
Dr. Michael Kanters, Associate Professor, Department of Parks, Department of Parks,
Recreation & Tourism Management, North Carolina State University, recommended that the
State Board of Education policy on interscholastic sports in grades 7-12 be changed to
include 6th graders. Dr. Kanters also mentioned that children who participate in sports are
more active than children who don’t participate in sports.
December 8, 2011
Ms. Jani Kozlowski, Policy Unit Manager, Division of Child Development and Early
Education (DCDEE), described the new nutrition rules that the Child Care Commission had
agreed upon on September 27, 2011. These rules are the result of S.L. 2010-117(HB 1726).
Original rules to help reduce childhood obesity had been developed in August, 2010.
Ms. Alice Lenihan, Branch Head of the Nutrition Services Branch, DPH, DHHS, described
the process of public hearings that had been used to gather input on the new nutrition
standards. They also learned about what different localities are doing to help preschool
children to be more active and to eat more healthy foods. Their Branch plans to work
collaboratively with DCDEE to implement new nutrition standards.
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Dr. Lynn Harvey, Section Chief, Child Nutrition Services, Department of Public Instruction,
presented a thorough overview of Federal Child Nutrition programs offered in each local
school administrative unit (LEA) and administered by DPI. She provided the history of the
program along with current successes and challenges. Overall program costs are increasing
and revenues are decreasing. Dr. Harvey concluded her presentation with information on
food insecurity, or lack of nutritious food, which is being experienced by many children in
North Carolina.
Dr. Carol Ripple, Principal Evaluator, Program Evaluation Division (PED), North Carolina
General Assembly, gave a report on a study that the PED had completed on NC’s Child
Nutrition program. The major findings of that study included (i) program viability depends
on a delicate balance of cost, nutritional value, and student participation; (ii) indirect costs
challenge program solvency; and, (iii) NC does not supplement federal funding beyond the
required match. The PED recommended that programs must be solvent, defined as having
one month’s operating balance, before LEAs can charge indirect costs and that the
legislature should support the NC Procurement Alliance. The Procurement Alliance helps
LEAs to buy food and products in bulk, and thus at lower rates.
Dr. Alice Ammerman, Professor, UNC-Chapel Hill School of Public Health, presented
information about a project that the School of Public Health is engaged in. This project
promotes the creation and consumption of healthy foods at local events such as barbecue
festivals. She also recommended supporting the Sustainable Local Food Advisory Council’s
report to increase the availability of locally-produced foods for SNAP participants.
January 12, 2012
Mr. David Locklear, Assistant Chief, Economic and Family Services, DHHS, explained
eligibility criteria for, and allowable benefits of, the Supplemental Nutrition Assistance
Program (SNAP), formerly called “food stamps.”
Ms. Veronica Bryant, SNAP-Ed Outreach Coordinator, DHHS, explained what this
program does. SNAP-Ed provides nutrition training and information to families who
participate in SNAP to support them to make health food choices. SNAP-Ed also provides
information on increasing SNAP participant physical activity as needed. Ms. Bryant provided
a list of agencies who offer SNAP-Ed and a list of counties served by the agencies. She
concluded her presentation with a description of SNAP-Ed partnerships and pilot projects
including the NC Farmers Markets.
Mr. Gary Gay from the Food Distribution Division in the Department of Agriculture and
Consumer Service explained how the Farm to School program works. He provided
information on what crops are available for schools to purchase during different times of the
year. The NC Farm to School Program served approximately one million students and
delivered over 1 million pounds of NC produce in 2010-11. He indicated that the major
barriers to schools participating in the Farm to School program include lack of refrigeration
space, staff to prepare fresh produce, and Good Agricultural Practices (GAP) certified
farmers.
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Ms. Laurie Stradley, the NC State Lead for the National Farm to School Network provided
evidence that buying local foods is beneficial for health and economic reasons. She
indicated that the components of a farm to school program includes more than just delivery
of fresh produce, but also includes field trips to farms, nutrition education and cooking in
schools, and school gardens. Ms. Stradley concluded her presentation to with several
recommendations to increase the number of schools and farms participating in the farm to
school program.
Ms. Joy Hicks, Policy Development Analyst, Department of Agriculture and Consumer
Services, gave the report form the NC Sustainable Local Food Advisory Council. In 2009,
the General Assembly established the NC Sustainable Local Food Advisory Council. Article
70 of Chapter 106 of the North Carolina General Statutes creates, and provides the duties
of, the Council but the Council is currently set to expire on July 31, 2012. In the Council's
2010 report, some of the recommendations related to reducing childhood obesity included
supporting the Farm-to-School program, expanding SNAP-Ed, supporting WIC and EBT
programs, increasing funding for school cafeterias, increasing local food purchases with
SNAP, and getting whole farms to be GAP certified. The NC Sustainable Local Food
Advisory Council is set to expire in 2012, but would like to have the expiration date
amended so that they can continue to pursue some of the efforts they have begun.
February 15, 2012
Mr. Ronnie Wynne and Ms. Brooke Stephenson from the Marketing Division of the NC
Department of Agriculture and Consumer Services provided an overview of how farms
become GAP certified. GAP stands for Good Agricultural Practices and the certification
process involves farms meeting a number of criteria and food safety procedures. Farms and
packaging facilities are inspected and farm workers are observed and interviewed. GAP
certification is voluntary and the type of certification is driven by the consumer of the
farmer’s products. The certification is used for safety, sanitation, and for marketing, e.g., a
restaurant who advertises local produce from a GAP certified farm.
Ms. Heather Barnes, Marketing Director, NC Farm to School Program, indicated that DPI
requires farms to be GAP certified before a school can buy produce from them.
Mr. Roland McReynolds, Carolina Farm Stewardship Association, further explained the
GAP certification process, and the positive reasons for having the certification, but also the
hardships placed on farmers going through this process. His group, working with the NC
Fresh Produce Safety Task Force, found that the current GAP certification process is not
well-suited for small-scale farms. They are developing an All-Farm GAP process pilot
project to see if this alternative would be less costly and easier for small farms to complete.
The project will produce a results report and guidance manual later this year.
Ms. Paula Hudson Hildebrand, Chief Health and Community Relations Officer, DPI, gave
the 2010-2011 Health Active Children Policy Report. According to data submitted to DPI
by 95% of LEAs, 51% provide 150 minutes of weekly physical education (PE) with PE
certified teachers to elementary school children and 52% proved 225 minutes of weekly
Healthful Living coursework with certified health and PE teachers. She indicated that cost of
certified teachers in these areas and equipment was hindering other school systems to meet
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these aspects of the Healthy Active Children Policy. Ms. Hildebrand included in her report
the successes of the local school health advisory councils including a significant reduction in
the use of exercise in schools as a punishment.
Representative LaRoque passed out a current report from the IsPOD which indicated that
teachers and students report less involvement in physical education and activity. Ms. Judy
Marino from IsPod and Ms. Hildebrand from DPI indicated that teacher and student
perceptions from their individuals schools and life experiences may be different from the
reports sent to DPI which reflect physical education and activity on the whole across an
LEA.
Ms. Pamela Smith, Child Nutrition Director, Lenoir County Schools, provided a local
perspective on running a child nutrition program. She talked about how Lenoir County
Schools had been running a significant deficit until they ended 25 positions through attrition,
reduced the variety of items on the menu, and participated in the NC Procurement Alliance.
Their Child Nutrition Program now does not pay indirect costs. She talked about
introducing more fresh fruits and vegetables to all children who come through the cafeteria
lines and that fresh salads had actually become a popular item with all of the children. She
concluded her presentation with a description of how cashiers have to charge children based
on different elements required by the USDA and how Lenoir County Schools uses
lunchprepay.com that allows families to keep funds available for their child to use and know
what foods their child purchases.
Dr. Patrick Miller, Superintendent, Greene County Schools, shared their “success story” in
being able to meet the State Board of Education’s Healthy Active Children policy. He said
that they had prioritized their small system and low wealth system funds to hire certified PE
teachers in each of their schools in 2006-2007. He said that they had seen a decrease in
behavior referrals since being able to offer PE and/or “energizers” to all of their students on
a daily basis.
Ms. Angie Miller, Healthful Living Coordinator, Nash-Rocky Mount Public Schools,
presented their “success story” as they had also been able to meet the State Board of
Education (SBE) policy of providing daily physical activity. Her school system partnered
with the local hospital and YMCA to offer incentives such as water bottles and jump ropes
to children when they walked a number of miles. Each student walks a targeted amount per
day with their teacher in this school system.
Dr. Lynn Harvey concluded this meeting by presenting the new federal nutrition standards
which were mandated on January 26, 2012 with passage of the final rule on meal pattern and
nutrition standards. Dr. Harvey explained the differences in the amounts of each component
required by the USDA. More fruits, vegetables, and whole grains will be required. Reduced
sodium, calories, and trans fat will also be required. The cost estimate of implementing the
new nutrition standards is an estimated 10 cents for each lunch and 27 cents for each
breakfast. The final rule states that “school districts will be required to make a substantial
investment to improve the quality of school meals.” As such, Dr. Harvey indicated that
State and local governments will likely be expected to play a significant role in coming up
with the funding for improved nutrition standards. Additionally, Dr. Harvey highlighted
barriers to an optimal nutrition environment which supports obesity prevention including:
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inadequate funds; nutrition not valued as part of the instructional day; priority for the child
nutrition program to be financially self-supporting; limited time and or space for students to
eat meals at school; too little nutrition education; and student taste preferences. There will
be a gradual implementation of the new nutrition standards over the next three years.
April 25, 2012
The chair recognized Committee staff to go through the draft Committee report and the
draft recommendations and corresponding bill drafts. Theresa Matula provided information
on the Committee's purpose and reporting requirements as contained in the Committee
authorization. Ms. Matula reviewed the elements of the report and explained the first four
draft recommendations and corresponding bill drafts. Sara Kamprath explained the
remaining seven draft recommendations and corresponding bill drafts. After each draft
recommendation and bill draft was explained by staff, the Committee discussed the
recommendation and bill draft making any changes deemed appropriate. The Committee
voted to approve each draft recommendation and corresponding bill draft.
15
FINDINGS AND RECOMMENDATIONS
Improving Child Nutrition Programs
Recommendation 1: The House Select Committee on Childhood Obesity
recommends that the General Assembly appropriate:
 $20 million dollars for the 2012-13 fiscal year to the Department of Public
Instruction to assist child nutrition programs in meeting nutrition standards.
and
 $1.7 million dollars for the 2012-13 fiscal year to the Department of Public
Instruction to support the elimination of the student cost of the reduced-price
breakfast in order to increase the participation rate.
and
 funds for the 2012-13 fiscal year to the Department of Public Instruction to
support the cost of any increases in salaries and benefits required by the State
for child nutrition personnel.
These recommendations are contained in bill drafts 2011-SHza-12, 2011-SHza-13,
and 2011-SHza-14.
Background 1: The Program Evaluation Division report on December 8, 2011, indicated
that 32 states supplement federal child nutrition funds. Some states have a recurring flat
appropriation amount, some fund labor costs, and some provide meal reimbursements. The
Department of Public Instruction indicated that since 2007, the State Board of Education
has requested $20 million annually to assist Child Nutrition programs in meeting nutrition
standards. Following the Committee’s March meeting, the Department of Public Instruction
provided supplemental information indicating a cost of $1.7 million dollars to eliminate the
student cost of a reduced-price breakfast for children who qualify for reduced-price meals.
Recommendation 2: The House Select Committee on Childhood Obesity
recommends that the General Assembly require the Department of Public
Instruction to work with school districts to decrease food costs and increase the use
of locally grown fresh fruits and vegetables through 1) increased participation in the
North Carolina Procurement Alliance and 2) increased participation in the Farm to
School program, and to report progress on this recommendation on or before
November 1, 2013, to the Joint Legislative Education Oversight Committee. To
support these initiatives the House Select Committee on Childhood Obesity
recommends that the General Assembly appropriate $80,000 for the 2012-13 fiscal
year to the Department of Public Instruction to provide administrative support for
the NC Procurement Alliance; and to appropriate $5,000 to the Department of Public
Instruction for each school district, for a total of $575,000 for the 2012-13 fiscal year,
to purchase chopping/slicing devices, or other equipment, that would encourage the
purchase and consumption of locally grown fresh fruits and vegetables in school food
services.
This recommendation is contained in bill draft 2011-TLza-17.
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Background 2: The Program Evaluation Division report on December 8, 2011, presented
information on opportunities for child nutrition programs to save money when purchasing
food and supplies through the North Carolina Procurement Alliance. The Division found
that Members have realized an average savings of 6% on the purchase of food and supplies.
The Division recommended funding administrative support for the Procurement Alliance in
the amount of $80,000.
Following the Committee’s March meeting, the Department of Public Instruction provided
information indicating that 87 school districts currently participate in the Procurement
Alliance. The Department funds a position to support the work of Alliance and the
remaining support is provided through federal grants and the efforts of school district
volunteers. The Department indicated that the funds provided to support the Procurement
Alliance are not sufficient to enable the buying group to operate at an optimal level or to
expand.
During meetings on January 12, 2012, and February 15, 2012, the Committee heard
presentations on the North Carolina Farm to School Program coordinated by the North
Carolina Department of Agriculture. The Farm to School program has been in operation for
15 years. Comments by the Committee members indicated that the purchase of locally
grown produce from farmers and the consumption of this produce by school children was a
win-win situation for North Carolina. However, some concerns were shared with the
Committee that many school kitchens are not equipped to handle the preparation of fresh
fruits and vegetables for consumption by children.
Following the Committee’s March meeting, the Department of Public Instruction provided
information on the need for funding to support the purchase of equipment that supports the
use of fresh, locally-grown produce. Within the last several years, districts did receive some
federal funding for equipment purchases. However the equipment requests received totaled
$12.5 million, but the funding received was only $3.2 million. Equipment needs include:
pass-through refrigerators, refrigerated display cases, chopping/slicing devices, and walk-in
coolers. The Department indicated that a vertical cutter mixer would cost approximately
$5,000 and could facilitate the use of fresh produce.
Recommendation 3: The House Select Committee on Childhood Obesity
recommends that the General Assembly amend G.S. 143-64 to remove “local school
administrative units” which is anticipated to save $500,000 by removing the
requirement that school districts procure juice and water separately from other foods
and beverages.
This recommendation is contained in bill draft 2011-SHz-15.
Background 3: Following the Committee’s March meeting, the Department of Public
Instruction provided information indicating that G.S. 143-64 requires local school
administrative units to competitively bid contracts for the sale of bottled water separately
from each other and separately from any other contract. The Department reported that this
requires school districts to procure juice and water separately from each other and from all
other foods and beverages served in the school breakfast and lunch program and the
approximate cost of this administrative burden exceeds $500,000. The Department reported
that all purchases of foods and beverages in the child nutrition program are made in
17
compliance with federal regulations. An amended version of G.S. 143-64 has been provided
below.
§ 143-64. Beverages contracts.
Notwithstanding any other provision of law, local school administrative units,
community colleges, and constituent institutions Notwithstanding any other provision of
the law, community colleges and constituent institutions of The University of North
Carolina shall competitively bid contracts that involve the sale of juice or bottled water.
Contracts for the sale of juice and contracts for the sale of bottled water shall each be
bid separately from each other and separately from any other contract, including
contracts for other beverages or vending machine services. The local school
administrative units, community colleges, Community Colleges and constituent
institutions may set quality standards for these beverages, and these standards may be
used to accept or reject a bid.
Recommendation 4: The House Select Committee on Childhood Obesity
recommends that the General Assembly require the State Board of Education and
the Department of Public Instruction to determine the optimal amount of seat time
students need for breakfast and lunch and to explore innovative options for utilizing
meal time as instructional time and to report on or before January 1, 2014, to the Joint
Legislative Education Oversight Committee.
This recommendation is contained in bill draft 2011-TLz-18.
Background 4: On December 8, 2011, Child Nutrition Services reported the following
breakfast participation levels: 37% in Elementary School, 19% in Middle School, 12% in
High School. The following lunch participation levels were reported: 77% in Elementary
School, 69% in Middle School, 42% in High School. According to information presented by
the Department of Public Instruction, North Carolina has the tenth most food insecure
student body in the nation and the fifth fattest student body in the nation. For some
students a school breakfast and/or lunch may provide a significant portion of their daily
food intake. Many studies have shown a link between decreased instructional outcomes
when children are hungry. The Committee expressed concerns that all school students may
not have adequate time to go through the cafeteria line and to eat breakfast and lunch.
However, it is not clear how much time is appropriate. The Committee also expressed an
awareness of the importance of instructional time. The Department mentioned several
options that included “grab and go” meals and other options which may include facilitating
students eating breakfast in the classroom. A study would explore both the optimal seat
time and innovative approaches to ensuring students have the opportunity to eat breakfast
and lunch.
Increasing the Consumption of Healthy Food in Communities
Recommendation 5: The House Select Committee on Childhood Obesity
recommends that the General Assembly require the Department of Health and
Human Services to increase participation in Supplemental Nutrition Assistance
Program Education (SNAP-Ed) and to report progress on or before October 1, 2013,
to the Joint Legislative Oversight Committee on Health and Human Services.
This recommendation is contained in bill draft 2011-TLz-19.
18
Background 5: On January 12, 2012, the Division of Social Services, Department of Health
and Human Services, presented information on Food and Nutrition Services and
Supplemental Nutrition Assistance Program Education (SNAP-Ed). SNAP-Ed is an
optional nutrition education and obesity prevention grant program that is 100% federally
funded. The Division provided that the goals of SNAP-Ed include: healthy food choices
within a limited budget, physically active lifestyles, and education on Dietary Guidelines for
Americans and MyPlate. The focus of the program is to encourage consumption of fruits,
vegetables, whole grains, and fat free or low-fat milk instead of unhealthy alternatives. The
program also encourages physical activity, caloric intake monitoring and drinking water
instead of sugary drinks.
Recommendation 6: The House Select Committee on Childhood Obesity appreciates
and supports efforts to assist farmers in becoming Good Agricultural Practices (GAP)
certified in order to increase participation in the Farm to School program and to
increase the availability, supply and consumption of healthy locally grown fruits and
vegetables.
No legislation is necessary for this recommendation.
Background 6: During the meetings on January 12, 2012 and February 15, 2012, the
Committee heard presentations on the Farm to School program and Good Agricultural
Practices (GAP) certification for farmers. The Committee appreciates current and future
efforts by the Department of Agriculture and the Carolina Farm Stewardship Association to
assist farmers in obtaining GAP certification thereby increasing local farmer participation in
the Farm to School program and public access to healthy fruits and vegetables.
Recommendation 7: The House Select Committee on Childhood Obesity
recommends that the General Assembly require the Department of Health and
Human Services, the Department of Agriculture & Consumer Services to work
toward increasing the number of farmers markets accepting SNAP (Supplemental
Nutrition Assistance Program) EBT (Electronic Benefit Transfer) cards, to make the
location of these markets known to SNAP recipients, and to report progress on this
recommendation on or before March 1, 2013 and November 1, 2013, to the Joint
Legislative Oversight Committee on Health and Human Services.
This recommendation is contained in bill draft 2011-TLz-19.
Background 7: During the January 12, 2012 meeting the Committee heard a presentation
on SNAP and SNAP-Ed. At the December 8, 2011 meeting, the Committee heard from Dr.
Alice Ammerman, Professor, Department of Nutrition, Gillings School of Global Public
Health and School of Medicine Director, Center for Health Promotion and Disease
Prevention, University of North Carolina at Chapel Hill, who presented information on
SNAP-Ed and the economic case for local food. Dr. Ammerman presented
Recommendation 13 from the Sustainable Local Food Advisory Council's 2011 report,
which encouraged the SNAP-Ed Advisory Committee to work with the Council's
subcommittee to consider a statewide coordinated approach to encourage the use of locally
produced food by SNAP participants. The Committee is encouraged by the work thus far to
increase the acceptance of SNAP EBT cards at farmers markets. Increasing acceptance of
these cards will assist farmers and SNAP recipients by increasing consumption of locally
grown fruits and vegetables.
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Recommendation 8: The House Select Committee on Childhood Obesity
recommends that the General Assembly continue the Sustainable Local Food
Advisory Council until July 31, 2015.
This recommendation is contained in bill draft 2011-TLz-20.
Background 8: Session Law 2009-530 created the North Carolina Sustainable Local Food
Advisory Council to address program and policy considerations regarding the development
of a sustainable local food economy in North Carolina. The Council is set to expire on July
31, 2012. The Committee has heard from a number of groups that are involved with the
Council and has benefited from information facilitated through the Council. The Council
has requested continuation.
Increasing Physical Activity Among Children
Recommendation 9: The House Select Committee on Childhood Obesity
recommends that the General Assembly establish the Task Force on Physical
Education and Physical Activity in Schools (Task Force) to examine strategies for
increasing physical activity and quality physical education instruction in the public
schools. In the course of the study, the Task Force shall consider and recommend
to the General Assembly a strategic plan to:
 Increase the amount of time that K-8 students are engaged in daily moderate
to vigorous physical activity.
 Increase the number of K-8 students that are receiving the amount of weekly
physical education recommended by the State Board of Education.
 Provide adequate facilities, equipment, and licensed physical education
instructors.
 Identify local and statewide funding sources, including potential public-private
partnerships.
 Identify methods to provide and fund the collection of reliable data from
fitness testing that can be used to monitor and improve student health.
The Task Force shall consider any recommendations that are received from the State
Board of Education work group on fitness testing data and use. The Task Force
shall also identify any other barriers to increasing physical activity and quality
physical education instruction in the public schools and recommend any means to
overcome those barriers. The Task Force shall include members of the North
Carolina Senate and House of Representatives; representatives from the Department
of Public Instruction; the Division of Public Health in the Department of Health and
Human Services; and other interested stakeholders. The Task Force shall report
interim progress on this recommendation on or before March 1, 2013 and shall
provide a final report on or before March 15, 2014 to the Joint Legislative Education
Oversight Committee.
This recommendation is contained in bill draft 2011-RJz-4.
Background 9: At the November 10 meeting, the Committee heard about the link between
the amount of time that a child participated in daily activity and the child's grades in school.
According to the Physical Activity and Nutrition Branch of DHHS, parents reported that
20
53% of children who spent over an hour in physical activity each day made mostly A's as
compared to 42% of children who spent less than 20 minutes in physical activity each day
made mostly A's.
Paula Hudson Hildebrand, Chief Health and Community Relations Officer for DPI,
explained State Board of Education Policy HSP-S-000 that required schools to provide daily
a minimum of 30 minutes of moderate to vigorous physical activity to all K-8 students. The
requirement can be met through a regular physical education class or through other activities
such as recess, dance, classroom energizers, or other curriculum based physical education
activity programs. This time should not substitute for the physical education program.
During the February 15, 2012 meeting, Ms. Hildebrand provided the results of a 2011 study
on the percentage of local school administrative units (LEAs) that are meeting the
requirements of this policy. DPI combined city and county LEAs for the purposes of this
report and 106/112 (combined LEAs) provided data. Slightly over half (51%) of the
reporting LEAs indicated that all of their elementary schools are meeting the suggested 150
minutes per week with a certified Physical Education teacher. Slightly over half (52%) of the
reporting LEAs indicate that all of their middle schools are meeting the suggested 225
minutes per week of Healthful Living instruction taught by a certified Health and Physical
Education teacher. Therefore, it appears that only about half of the State's school children
are being provided with physical education by a certified PE teacher.
During the November 10th meeting, Dr. Michael Kanters, Associate Professor, Department
of Parks, Recreation & Tourism Management, NCSU, spoke on the importance of providing
intramural opportunities for students who do not participate in interscholastic athletic
competition. Dr. Kanters mentioned that children who participate in sports are more active
than children who don’t participate in sports. He pointed out that his research found that
about 32,000 6th graders don’t have access to any school sports. Dr. Kanters mentioned that
this is important because when children don’t participate in sports their motivation to
participate later diminishes. His research found that intramural sports attract more students
than interscholastic sports and that African American and low-income students are more
likely to participate in sports in schools that have intramural sports programs. Dr. Kanters
presented research indicating that 47% of schools offer some type of intramurals but that
sometimes facilities sit empty but intramurals more effectively use buildings.
Recommendation 10: The House Select Committee on Childhood Obesity
recommends that the General Assembly direct the State Board of Education to
coordinate a work group to examine how to continue the collection of data from
fitness testing currently conducted in the public schools, methods to ensure that the
data is reliable, procedures to allow the data to be shared appropriately with State
agencies in order to have a Statewide picture of fitness levels of students, and
funding sources for these activities. The work group should include representatives
from the Department of Public Instruction; the NC Alliance for Athletics, Health,
Physical Education, Recreation, and Dance; the Division of Public Health in the
Department of Health and Human Services; the American Heart Association; and
other organizations and agencies deemed appropriate. The work group shall report
to the Task Force on Physical Education and Physical Activity in Schools by June 30,
2013 on the results of its work.
This recommendation is contained in bill draft 2011-RJz-4.
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Background 10: At the November 10 meeting, Paula Hudson Hildebrand, Chief Health
and Community Relations Officer for DPI, explained about the new fitness testing
guidelines for K-8 students developed by the State Board of Education as required by
Session Law 2010-61. The new tests should measure aerobic capacity, body composition,
muscular strength, muscular, endurance and flexibility. At the same meeting, the Committee
heard that the Kate B. Reynolds grant funding that supports the efforts of the NC Alliance
for Athletics, Health, Physical Education, Recreation, and Dance (NC AAHPERD) will end
on July 31, 2012. Through the grant NCAAHPERD has collected data on the fitness levels
of K-8 students.
Following the Committee’s March meeting, the State Board and DPI provided information
that DPI had lead the task force that initially developed the new fitness testing guidelines
and would be the logical entity to lead this new task force.
Addressing Early Childhood Obesity
Recommendation 11: The House Select Committee on Childhood Obesity
recommends that the North Carolina Institute of Medicine (NCIOM) present the
findings and recommendations of the NCIOM Task Force on Early Childhood
Obesity Prevention to the Joint Legislative Education Oversight Committee when
those findings are available in 2013.
No legislation is necessary for this recommendation.
Background 11: The North Carolina Institute of Medicine (NCIOM) Task Force on Early
Childhood Obesity Prevention is working to develop recommendations to address barriers
and to ensure the availability of systems and services to improve young children, ages 0-5,
and the physical and nutritional health of their families. According to information from the
NCIOM, the Task Force is charged to:
(1) examine evidence-based and promising practices from prior North Carolina
related task forces, as well as from the White House and national Institute of
Medicine Committee on Childhood Obesity Prevention; and
(2) develop a strategic plan to prevent or reduce early childhood obesity in North
Carolina that can serve as a blueprint for foundations, government, health
professional associations, and other community groups interested in improving
the health of young children, ages 0-5
LEGISLATIVE PROPOSAL I
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EGISLATIVE PROPOSAL II
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LEGISLATIVE PROPOSAL III
24
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LEGISLATIVE PROPOSAL IV
25
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LEGISLATIVE PROPOSAL IV
26
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LEGISLATIVE PROPOSAL V
27
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LEGISLATIVE PROPOSAL VI
28
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LEGISLATIVE PROPOSAL VII
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EGISLATIVE PROPOSAL VIII
30
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12
LEGISLATIVE PROPOSAL IX
31
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LEGISLATIVE PROPOSAL IX
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LEGISLATIVE PROPOSAL IX
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